Warts (Common Warts) (cont.)

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Is using over-the-counter wart treatments safe?

It is important to follow the directions when treating warts with nonprescription medications. If salicylic acid gets on normal skin, it can cause burning or redness but rarely infection or scarring. The skin returns to normal when the individual stops applying the salicylic acid product. Still, it's probably better not to use salicylic acid on sensitive areas like the face or groin, where it's likely to make nearby skin raw and uncomfortable. It generally is recommended that salicylic acid not be used in people with diabetes or in areas where there is poor circulation. Likewise, nonprescription freezing products are also reasonably safe but must be used carefully and only according to package instructions because they work by destroying living tissue.

Are wart treatments effective?

Above all, wart treatments require patience. The fact that there are a wide variety of wart treatments is evidence for the fact that there is no single best therapy. Warts can appear and disappear without an identifiable cause and often disappear on their own without treatment. Some warts sprout daughter warts near the main wart and others don't. Warts are generally painless unless they are present in areas prone to pressure or friction like the palms and soles. Certain warts, even of the same type, respond to treatment, while others (even on the same person at the same time) don't. Treatment methods may require many sessions over weeks, months, or longer.

Here is a practical approach to the treatment of warts:

Ignore the warts. Eventually, they'll go away (although eventually can mean a long time -- even months or years).

With an uncomplicated case (a single wart on the face or one or a few on the hands), see a doctor for a quick freeze or electrical destruction. These methods are simple, although somewhat painful, and generally nonscarring.

With a difficult case, start by treating the warts for a few weeks at home. Here are some examples:

Plantar warts: Warts on the bottom of the foot feel deep, but they are still within the superficial layer of the skin. Tender plantar warts can be rendered painless by paring the wart thinner without causing bleeding. Salicylic-acid drops and plasters help remove the thick overlying callus and make the wart feel less like a marble in the shoe. Nonprescription aerosol freezing may be used as well.

Common hand warts: These are typically unattractive although not painful. Salicylic acid can make them smaller and go away, in some cases, as can nonprescription freezing.

With an all-but-impossible case, don't try too hard. Don't make the treatment worse than the disease. Here are some examples:

Warts under and around the nails: These are extremely resistant to treatment. One or two tries by the doctor are worth a shot, but if they fail, putting acid on them oneself just makes them look rough and unattractive.

"Mosaic" warts: Tiny, so-called "seed warts" can proliferate by the dozens or hundreds all over the sole of the foot. They don't usually hurt, and they rarely respond to any sort of treatment, although in this case, too, one or two tries at treatment may be in order.

Flat warts: These are small, flat, flesh-colored pimples and may be numerous on one part of the body (for example on the face, arms, or groin). Getting rid of them by a light application of salicylic acid or other method is easy enough, but they have a tendency to recur.